Conservator Owes Duty to Nursing Home to Timely Apply for Medicaid

A Connecticut appeals court has held that a nursing home resident's conservator owes a duty of care to the nursing home to timely apply for Medicaid on behalf of the resident. Bloomfield Health Care Center of Connecticut, LLC v. Doyon (Conn. App. Ct., No. AC 40281, Oct. 9, 2018).

A nursing home petitioned the court to appoint a conservator for one of its residents, Samuel Johnson, to assist him with his Medicaid application. The court appointed Jason Doyon as conservator in April 2014. Mr. Doyon waited nine months to file a Medicaid application on Mr. Johnson's behalf. The state denied Mr. Johnson's first Medicaid application due to lack of information. Mr. Doyon filed a second application, which the state approved, but Mr. Johnson did not receive any Medicaid benefits before May 2015.

The nursing home sued Mr. Doyon for negligence in failing to apply for and obtain Medicaid benefits on behalf of Mr. Johnson in a timely manner. Mr. Doyon asked for summary judgment, arguing that he did not owe a duty of care to the nursing home. The trial court granted Mr. Doyon summary, holding that the conservator owed no duty to the nursing home.  The nursing home appealed the lower court's judgment.

The Connecticut Court of Appeals reversed.  The court held that Mr. Doyon owed the nursing home a duty of care. The court rules that it was "readily foreseeable that, if [Mr. Doyon] failed to timely obtain Medicaid benefits for [Mr.] Johnson, the [nursing home] would suffer harm as a result because it would not be reimbursed for the cost of [Mr.] Johnson’s care." The court also concludes that "the benefits of encouraging conservators to carry out their duties with care and preventing financial harm outweigh any corresponding minimal increase in litigation."

The decision continues a trend of decisions favoring nursing homes when eligibility applications for Medicaid are not timely or properly prosecuted.  The decision should also concern family caregivers; the trend might foreshadow greater success on the part of nursing homes in disputes with family members who act as fiduciaries without court appointment.  Family often acts in court-appointed roles, or more informal roles without careful consideration of the liabilities of service. The bottom line is that Medicaid applications should be taken seriously, and the applications completed and submitted as quickly as possible.